Basic Information
| Provider Information | |||||||||
| NPI: | 1841473345 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BILL BURKE, DO A PROFESSIONAL ASSOCIATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | 808 KELLER PKWY | ||||||||
| Address2: | |||||||||
| City: | KELLER | ||||||||
| State: | TX | ||||||||
| PostalCode: | 762482405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8174312573 | ||||||||
| FaxNumber: | 8173796881 | ||||||||
| Practice Location | |||||||||
| Address1: | 808 KELLER PKWY | ||||||||
| Address2: | |||||||||
| City: | KELLER | ||||||||
| State: | TX | ||||||||
| PostalCode: | 762482405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8174312573 | ||||||||
| FaxNumber: | 8173796881 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/07/2007 | ||||||||
| LastUpdateDate: | 12/07/2007 | ||||||||
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| AuthorizedOfficialLastName: | BURKE | ||||||||
| AuthorizedOfficialFirstName: | JOSEPH 'BILL' | ||||||||
| AuthorizedOfficialMiddleName: | W. | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8174312573 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | III | ||||||||
| AuthorizedOfficialCredential: | D.O. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | G3197 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.